End-of-Life Care
Care arrangements in the United States could ensure that people living with eventually fatal chronic illness can count on living as comfortably and meaningfully as possible, in a sustainable care system. Our research focuses on learning how to achieve such arrangements. Some of the RAND Corporation's end-of-life studies are highlighted below.
Profiles of Current Research
Highlights of Recent Studies
Redefining and Reforming Health Care for the Last Years of Life — 2006
End-of-life care should be organized according to the kinds of services that groups of people need, rather than by disease diagnosis or where the patients receive care.
RAND Study Finds Choosing Hospice Care Raises Medicare Costs for the Last Year of Life — 2004
Hospice patients who died from illnesses other than cancer averaged costs that were 11 percent higher than those of similar patients who received standard medical care.
Vaccinating Residents and Staff Can Reduce Influenza Outbreaks in Nursing Homes
Immunizing nursing home staffs as well as residents is a key part of any strategy to reduce influenza outbreaks in nursing homes.
Trajectory of End-Stage Heart Failure: The Influence of Technology and Implications for Policy Change
Because heart failure patients often have treatable symptoms, such as dyspnea, fatigue, and generalized pain, by reexamining its health care spending priorities, the United States can create a sustainable care system that allows patients to live both long and comfortably, reaching a balance that serves them and their communities well.
Research Showing How to Improve Care for Heart Failure Rarely Reforms Services or Shapes Policy
Although researchers identified 30 studies of high-quality projects, 16 of them in the United States, that demonstrated improvement for patients, most in the United States ended after demonstrating success, whereas about half in other countries became permanent. Medicare's payment system generally does not reward health providers who find ways to keep patients out of the hospital.
Why We Know Painfully Little About Dying — 2005
More research and data on dying and the time just before death are needed, before the baby-boom generation begins to get old and sick together
Living Long in Fragile Health: The New Demographics Shape End of Life Care — 2005
Family caregivers are viewed as a potential powerful force for thoughtful reform so that people can live well while very sick and dying.
End-of-Life Care and Outcomes
Evidence concerning interventions to improve palliative and end-of-life care is strongest in cancer, reflecting the degree to which palliative care has already been integrated into the research agenda and clinical practice of oncology.
Research brief at ahqr.gov
Related Web Sites
RAND Southern California Evidence-Based Practice Center
http://www.rand.org/health/centers/epc
Palliative Care Policy Center
United Hospital Fund, Palliative Care Quality Improvement Initiative
http://www.uhfnyc.org/pubs-stories3220/pubs-stories_list.htm?attrib_id=5039
Working with Congress
RAND's Washington Office of Congressional Relations (OCR) furthers RAND's mission to provide objective analysis and effective solutions by disseminating research results to Congress and federal agencies. The OCR publishes a monthly electronic newsletter featuring current work on health policy. Contact: Shirley Ruhe (Shirley_Ruhe@rand.org) or Kristy Anderson (kristy@rand.org).
The RAND Health Congressional Newsletter
Top